Pulmonologist

                As I mentioned before, Dr. Malte is a pulmonologist working with us now.  He’s helping with all the patients a little but also our lung cases.  In the USA most of the chronic lung problems I cared for were complications of smoking: COPD, asthma, and lung cancer.  Here we have lots of lung cases but none are from smoking.  Smoking is very rare here.  I’ve had a couple patients who admit to occasional cigars, but never cigarettes.  Here the people cook with wood and work in silver, copper, and gold minds.  Also this time of the year at the end of the dry season everyone burns their fields. I still see a lot of COPD (destruction of the lung walls and hairs that move mucus and over production of mucus because of smoke and pollution) and asthma.  I also see a lot of tuberculosis (TB) and scarring from old tuberculosis infections.  Here if you have a patient with plural effusion (liquid levels at the base of the lungs) its TB until proven otherwise.  There’s also a lot of patients with pulmonary fibrosis (scar tissue of the lung as a result of chronic inflammation).  I have patients with pneumoconiosis and silicosis (chronic inflammation caused by toxins/metals they have breathed in while working.  I gave a bunch of my chronic lung patients’ appointments with the pulmonologist.  I’m thought he’d like the challenge.  I think he’s still trying to figure out how to treatment patients in our setting---where people who don’t have a lot of money have to pay for their CT, where the bronchoscopy is broken (pray for a new one), and where the medicines we have available are very limited. 

                This last week he saw one of my ladies who I’m treating for an Aspirgiloma (a ball of fungus in the lung).  She doesn’t want surgery (because she’d have to go to Cusco, and they don’t trust their own Peruvian doctors very much), so I’ve been treating her with Itraconazol 400mg every day for 4 months now.  The aspirgiloma is getting small little by little.  Average treatment length is between 2 and 13 months.

Neighbors

                Inessa and I live on the third floor of a 3 story building.  The owners live on the second floor.  The first floor is a party room.  On the roof live the guinea pigs and rabbits, and also there is a stone oven.  On the third floor are two apartments.  We’re in one and the other has been open for a while…but now it will be occupied.  Two young women (sisters) from Lima just signed contracts with Diospi: Daniza and Damaris.  Daniza studied theology and will be teaching at the Diospi school.  Damaris is a psychologist and will be working at both the school and hospital.  They came to the women’s group while they were interviewing here and I had a chance to hear them talk about their deep personal relationship with the lord.  They’re both probably in their early twenties.  I’m super excited to have them a Diospi but also as next door neighbors.

Ultimate Frisbee

                Thanks for your prayers. I was talking with the leadership of the local church I’m attending.  Our purpose in having ultimate Frisbee every week is so that teens and young adults who don’t currently attend evangelical churches can get to know the church, and then if we invite them to classes and services they are more comfortable and interested in coming.  We had been renting the gym at the Diospi school, but the rules were getting stricter every week: first non marking schools only, then only schools with rubber or white soles that had never been worn outside, and then they because concerned that even the white soles were leaving marks.  After praying over the issue, we decided to rent a turf field because the people we were targeting didn’t have money to buy a pair of shoes to only use once a week to play. 

                We’ve played Frisbee two weeks now in the synthetic grass field and God has really blessed it.  Both weeks we had nearly 40 kids, teens, young adults, and adults come out to play.  And mostly Peruvians.  The first night only 4 of us were foreigners, and the second only 10.  Prayers on wisdom and guidance on inviting those we reach to church.  The church is still very small.  There’s only about 5-10 of us available to take on the various leadership roles.  Miqui is in charge of the young adults. David just took on the Sunday school.  Jemerson, the pastor, is in charge of every time.  Juvenal is in charge of the music ministry.  I’m in charge of the weekly women’s group. Miqui and David are helping me with Frisbee.  There’s no one in charge of the teens yet.  They’re kind of added on to the young adult group or children’s Sunday school depending on their age and maturity.  Many of those coming to Frisbee fall in this teen group.  Please pray that God sends someone to fill this role in the church.

Vacations

                School vacations here are the hardest.  A week ago we finished a three week period of school winter vacations.  Some schools had the first 1-2 weeks off and the other the last 2 weeks.  At that time it was only Will, Martina and I seeing general medicine and pediatrics.  And will went on vacation for a week because his kids were off.  During vacations people travel from all over the country to wait in line to be seen.  They don’t like traveling during the school year because they don’t want their kids to miss classes and they don’t want to leave their small kids home alone more than 2-3 days.  The week of vacations that only Martina and I were seeing family medicine patients I worked until after 7 pm every day and had three overnight calls.  Praise the Lord, this last week a pulmonologist (Dr. Malte) started working (and is staying for a year), and a FP from the states (Dr. Alex Bruner) arrived (for 3 weeks) to help out with the load.  Please pray for more doctors.